Debljina dijafragme je povezana sa preživljavanjem kod starijih pacijenata sa povredom grudnog koša
Sažetak
Uvod/Cilj. Debljina dijafragme (DD) povezana je sa starijim životnim dobom i neželjenim ishodima, posebno u teškim stanjima kao što je prolongirana intubacija. Cilj rada bio je da se proceni prognoza kod starijih pacijenata sa povredom grudnog koša (PGK) i da se ispitaju DD i debljina mišića psoasa kao potencijalni prognostički pokazatelji. Metode. Retrospektivna studija je uključivala konsultacije u vezi sa PGK, preuzete iz bolničkih kartona, obavljene između novembra 2015. i januara 2021. godine. Dokumentovani su demografski podaci, karakteristike povreda, mehanizmi povreda, ukupno preživljavanje, itd. Radiološki snimci su ponovo procenjivani u cilju merenja DD i debljine mišića psoasa. Rezultati. Od ukupno 394 pacijenata, 129 je svrstano u populaciju starijih osoba (> 65 godina). Najčešći mehanizam povrede bili su padovi (n = 71), a sledili su ih saobraćajne nesreće pešaka (n = 16). Ukupno preživljavanje svih pacijenata iznosilo je 43,9 ± 3,6 meseci, sa stopom dvogodišnjeg preživljavanja od 82% za starije pacijente. DD je bila značajno veća kod starijih preživelih nego kod preminulih pacijenata (4,0 ± 1,19 mm vs. 3,57 ± 1,0 mm; p = 0,015). Zaključak. Smanjena DD povezana je sa povišenim rizikom od mortaliteta u populaciji starijih osoba. Starije osobe sa PKG i smanjenom DD mogu imati koristi od programa skrininga ranih intervencija usmerenih prema potencijalno doprinosećim faktorima kao što su slabost, recidivi povreda i propušteni skrining na karcinome. Osim toga, DD može služiti kao potencijalni pokazatelj u sklopu sistema bodovanja u proceni rizika.
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